What is the Expected Timeline for a Workers’ Compensation Claim?

What to Expect When Your Expecting (WC Benefits): Workers’ Compensation Lawyer in Greenville, South Carolina Shares Important Information

There are certain things in your life that always seem to take forever to arrive, such as the Winter Holidays, tax refunds, and workers’ compensation benefits—let’s be real, especially WC benefits. That’s because injured or ill workers can recover up to two-thirds of lost wages, medical bill reimbursement, and some other disability benefits when they are unable to work.

Our workers’ compensation lawyers in Greenville, South Carolina know that the longer a WC claim takes, the longer an individual and family may feel the financial burdens imposed on them by a workplace accident or incident. We understand, and we truly care.

If you or a loved one have suffered a work-related injury or illness in South Carolina and need help with your claim, call the Hammack Law Firm to schedule a free consultation to learn more about how we can help. Even if you think you can handle a claim on your own, there are two important truths about the workers’ comp system that everyone should know:

1) The only way to fully protect your rights and maximize your recovery is to have a workers’ compensation lawyer on your side. Although a WC employer or adjuster will tell you an offer is good, you have no way of knowing whether or not it is as good as
you can get unless you do this type of law for a living (which we do!). You’re entitled to a lawyer’s help, so you should definitely get one!

2) The WC claim system is nothing more than a game of chutes and ladders, where even a basic application error or oversight can slide you back down in the queue and cost you valuable time before your claim is approved. But having an experienced lawyer like
ours can help find “ladders” to ensure your claim is properly supported and proven, allowing you to sometimes get your approval faster when you have a very clear and meritorious claim.

Learn more about how our law firm can help you find more ladders and avoid the chutes by calling (864) 740-8653 to schedule your free consultation.

How Long Does it Really Take to Go From Injury to First Payment?

After you have been hurt or diagnosed with a work-related injury or illness, you just want to know how long it will take to start seeing the money (Maybe you’re even yelling “show me the money!”) The truth is, the amount of time varies based on factors of the local field office, what adjuster you are assigned to, the specifical facts of your claim, the type of your injury, and other random factors in the complex process which is workers’ comp. But generally, a worker who is injured or diagnosed with an illness can expect the following timeline:

1) Hurt Today, Now What?
Go go go – you only have 90 days from the date of your injury or illness (or when you learn about your injury or illness is work-related) to notify your employer. Sounds like a lot of time, right? Wrong! You may be really, really hurt and unable to give notice right away—including if you are at a hospital. This time goes fast—do NOT wait to notify an employer. Your failure to do so could result in your claim being outright barred—even if your boss is Wiley Coyote and he dropped an anvil on your foot so it’s clearly work-related, an untimely claim is an often denied claim.

Giving notice right away? That’s a ladder—cutting off the remaining time on that 90-day period. Waiting until day 90, that’s a chute—you could have had your claim almost two-three months ahead in the queue if you gave notice right away. Beyond 90 days? That’s a Clark Griswold- greased-up-sled chute. It’s time to call a WC lawyer in Greenville for help NOW.

2) You Gave Notice, Now What?
Once you tell your employer, your employer has 10 days to report your claim to the South Carolina Workers’ Comp Commission. This time period also goes by VERY fast, and an employer who fails to report the claim could face both civil and criminal penalties. Although there is no legal obligation for you to do so, make sure your employer complies with this! It will just make your life easier (and your claim faster) if your employer does what they are supposed to in the first place.

Wait—what? Your employer didn’t report your claim? That’s a chute—call our Greenville workers’ comp lawyers. We can help!

3) Filing Your WC Claim
Once your employer has filed your WC claim with the Commission, you have two years to file your formal paperwork. This is measured from when you knew “or should have known” about your injury, not the actual report date of your employer. That means you need to pay particular attention to the injury date, and not the date you gave notice during that 90-day period.

Filing right away and within the two years—a ladder. Filing at the end of the two years—a chute. And not filing within two years of when you knew “or should have known about your injury,” a vertical chute that requires you to call a South Carolina WC lawyer immediately. (Seeing a pattern here?)

4) Your Employer and WC Carrier Investigate
After you have formally filed your paperwork, your employer and the workers’ comp carrier will investigate your claim. They will most likely ask many questions relating to your accident and your injury or illness. This process can take anywhere from a few weeks (in serious or catastrophic cases) to more than a year (for trickier or more complicated cases, including cases with pre-existing injuries or where an employer may be contesting that the injury or illness was work-related).

The goal here is to timely respond to requests and fully answer all requests. Delays in responding or not fully answering can be a chute—especially if your application or responses are insufficient. Having an experienced WC lawyer can be a ladder to ensure your claim is properly completed the first time, and any questions are immediately and thoroughly handled.

It’s also important to note that most times you may already start receiving some WC benefits for medical bill reimbursement or for your medical bills to be paid by the carrier.

5) Woohoo—Claim Approved!
If your claim is very thorough and well-established (like when you have us as your lawyer, hint hint!), your claim may be approved and you’ll start to see benefits in 15-45 days, usually on the shorter end of this timeframe. A prime example of how a lawyer can be a major ladder!

6) Womp Womp—Claim Contested or Denied
If you did not hire an experienced lawyer, or if you otherwise failed to timely or properly respond to the workers’ comp carrier or your employer, your claim may be outright denied (usually when the carrier questions the cause, nature, or extent of injury) or your claim may be contested.

If your claim is contested, the other side will file a form 51. This form sets out a response to your allegations in the filed paperwork that you submitted. Your claim may be sent to a mediator, or it may be scheduled for a hearing with the assigned workers’ comp hearing commissioner. This process usually takes 1-3 months and is often a time chute.

During the time from your claim being contested to your hearing, there is often an exchange of medical information and negotiations to help resolve the issues raised by the other side.

Sometimes you may need to go to an independent medical examination by the workers’ comp carrier (hint hint, it is not so “independent” when the other side is paying for it. If this happens to you—you absolutely need to get a workers’ comp lawyer to help you!).

7) Time for a Hearing
Although sometimes a hearing is truly necessary and there is no way to avoid it—even with an experienced WC attorney—oftentimes, it can be avoided with a lawyer like ours. The reason why you want to do that is that a hearing can be a major kick down the chute—taking between 3 and 5 months to occur from the date the other side filed the form 51 contesting your claim. That is a lot of time to be facing financial uncertainty.

8) Decision Time
Although some hearings will result in a decision right there, very complicated matters may take an additional 1-2 months to receive an “opinion and award.” This is the decision relating to your claim which approves or denies your claim and sets forth the monetary amount of the award.

9) Woohoo-Claim Approved!
You’ll get your benefits starting in about 15 to 45 days, usually on the quicker side.

10) Not Again—Claim Denied!
The first time you got a notice that your claim was contested was back when the other party filed a form 51. That’s disappointing because it’s like a denial for most people who are truly hurt due to a workplace injury or accident. But when you get this “opinion and award” and it denies your claim, it can really be very overwhelming. It basically means the process is over unless you appeal, which is yet another extra step.

Having a lawyer that can help you prevent this from happening is very important—although it’s important to note that it can still happen in certain complex instances, with even the best lawyer.

11) Appealing a Claim
After an “opinion and award” is issued, either party can appeal the decision. The appeals process can take 2 to 4 months from the time of filing an appeal, submitting briefs, making arguments, and receiving a decision. This process is often the longest part of a claim, but fortunately, most people do not get to this part.

12) Appeal Denied—Now What?
If your appeal is denied, you have to file an appeal to a circuit court within 14 days of the denied appeal. This process is much rarer and begins the court process where you are not being handled by the administrative agency anymore, but rather you are in the court system. This legal process can take 12 months or longer. There are various steps, including the potential for other appeals—although those are rare, too.

Need Help With Your Workers’ Comp Claim in South Carolina? Call Our WC Lawyer in Greenville, SC for Help

As you can see, some workers’ comp claims can take a long time, while others can be quickly handled and processed. The timeline given above is just a guide, and there are many factors that could influence the timeline of your case. Some examples may include surgeries that may extend the waiting period before you reach your maximum medical improvement (MMI), pandemic-related delays, and Bigfoot sightings (or maybe even all three).

Although there is no requirement to have a lawyer when you file a workers’ compensation claim, there are many opportunities for a lawyer to help speed up the timeline for you by both climbing ladders and avoiding common pitfalls and chutes.

If you or a loved one have a workers’ comp claim in South Carolina, call the Hammack Law Firm to schedule a FREE consultation with our experienced workers’ compensation lawyers in Greenville, SC by calling (864) 740-8653 or by sending us a message via our website.